February 25, 2013

Tethered

I was in Wisconsin this past weekend participating in a writing retreat centered on telling our stories as mothers. One of my goals of the last two years has been to make sense of Merritt’s preterm birth, and the NICU stay that followed.

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Last week, in response to a post about Merritt’s second birthday, in which I expanded on some of the feelings I still carried for Merritt’s birth and early days, a reader commented:

“I have been following your posts for quite some time now. I guess I don't quite understand why the premature birth and NICU stay are so traumatic for you still. The important thing is that he's healthy, I'm sure you agree . . . but I also feel like you think that statement is trivializing your feelings. Many, many (did I say many?) women don't experience the birth that they dreamed of, for different reasons. I feel like in the long run, it doesn't matter. My relationship with my oldest child isn't changed by the fact that I broke down and got an epidural. Your relationship with Merritt is not changed by the fact that he was in the NICU for a short time.”

I replied directly to her comment and have thought quite a bit about what she said, and what she didn’t say, which has since made me wonder if the bigger question isn't: Don't we as mothers/women deserve space to feel our experiences for what they are and are we free to be impacted by them in whatever ways that we are affected (whether those feelings are positive or negative); or do we treat birth and the events that may precede or follow as different in our culture in that we use shame to manipulate women into believing that our Truth has no place at the table in the face of a thriving (or even living) child?

The grief I feel for Merritt’s birth affects me when I think about it, and I don’t think about it that often. I think about it most when something in the present recalls me back to his beginning as a measure of his growth or development. Just as Roscoe was born under ideal circumstances, when his birthday comes around I am drawn to recall the memories that I have of his beginning. Both are equally important chapters of our story.

As part of one of my writing exercises at the retreat, I revisited the reflection post I wrote soon after Merritt’s first birthday and tried to identify the under-developed theme, finally settling on the word “tethered.”

Tethered:
1. A rope or chain, or the like, by which an animal is fastened to a fixed object so as to limit its range of movement.
2. The utmost length to which one can go in action; the utmost extent or limit of ability or resources.

I know only one way to mother, and I wanted to mother Merritt in that way despite his prematurity. He was not a baby too sick to be mothered, who needed to rely more on technology for his survival. No. He was a small and hearty baby born early, who deserved to be cared for in all the ways that I was willing and able to meet his need. I was disempowered by the NICU's protocols and routines, an environment in which it was normal and common to assume that I would relinquish his care to staff nurses who did not, from my perspective, understand my needs as his mother, nor our family’s philosophy and parenting priorities.

Trying to be my momma-self in a discordant environment was incredibly unpleasant. My attempts to foster attachment were met with doubt, uncertainty, dismissal, and rejection. I felt alone and vulnerable. It was exhausting to be on guard, vigilant, never taking a mental break, and rarely stepping away from his isolette for fear of Merritt losing his voice. I now know that not all mothers face these issues in the NICU, but we did.

It was a painful struggle to toe that line between accepting the circumstances, working within the spoken and unspoken boundaries, and being true to myself as his mother to advocate for Merritt's right to receive the safest and healthiest birth and newborn care based on the best evidence. In the NICU these issues largely revolved around when I could pick him up and for how long, pain management, and breastfeeding. I suffered from palpable anxiety and stress in those weeks we lived in the NICU. It was traumatic for me as his mother to go through something like that when my frame of reference for what it is to be a mother came from a perspective of having had an easy and ideal birth and postpartum with my first baby. Knowing what could be made it more difficult to accept the inherent limitations of the NICU, a microcosm of separation and detachment.

I also hold a space for Merritt, and a sense of unfairness that my ability to protect and comfort him within the scope of my role was limited by the outdated routines of the hospital in which he was kept. When choosing between following the rules and betraying my child, I picked my battles carefully, and made decisions in spite of what I believed to be right, in order to conserve my limited resources.

*

I arrive at the nurse’s station disheveled and in a hurry, excited to see Merritt. It’s 7:20 in the morning, ten minutes before his first feed of the day. I spent the night at home, slept four or five hours and now I’ve returned with another full day ahead.

“Hi.” I smile wearily. “I’m here to see my baby in the NICU. Meritt?” I’m loaded down with a back pack and tote bag. I am very aware of my own appearance in contrast to the nurse's shiny hair, pulled back in a low ponytail, her full face of makeup, and rested eyes. I think they feel sorry for me, trekking back and forth.

“What’s the last name?” she asks, picking up the phone to dial the extension.

“Sears.” I reply.

“Oh sure,” she smiles, seeming to remember me, “Let me just call back and see if it’s a good time.” She pauses, waiting for someone to pick up, “Mrs. Sears is here to see her baby, can Merritt have a visitor?” She looks up at me with raised brows, expectant. Her mouth turned up at the corners.

Of course he can have a visitor, I think. The formality of this is so stupid.

“Oh.” Her voice falls. I study her face, annoyed that we have to go through this ritual every day, now trying to guess as to what the nurse on the other line is still talking about.

“Ok,” her brow furrows, forging a line between them, “how long will it be?” She pulls the phone from her ear and places it to her chest as if to protect the nurses from my response. Her mouth scrunches up to warn me, “They’re getting ready to replace Merritt’s line so it will be about a half hour.” She moves her mouth to reveal only her bottom teeth and sucks in a breath of air. She knows.

I lock eyes with her, my face is stern, “Oh." I swallow hard. "Well...yeah, I want to be there while they place the line. I want to be back there, will you ask them if I can?” Panic rises in my body, I begin to feel hot.

She nods her head then brings the phone back to her ear, “Mom says she wants to be present, is that possible?”

I interrupt, “I want to talk to the charge nurse,” my lips press together in a frown.

I’m gripped with helpless fear. I think back to two days before when I cradled Merritt skin-to-skin after a feeding, only a curtain separating our space from the baby’s next door. Three different nurses tried unsuccessfully to place a line in Merritt’s neighbor. One after the other. That baby’s mother wasn’t around. That baby had no advocate. One after the other, amidst the unbroken and desperate wails of the baby, I could hear the air escaping their lips as they missed. First one, then the next, then the next. It went on for more than 30 minutes before they decided to give that tiny little baby a break.

That will not be Merritt.

The nurse hands me the phone.

“What’s going on?” I demand.

“Jacqueline, this is Helen, how are you?”

“Fine. What’s going on?”

"Merritt’s line needs to be replaced.” She begins. “Remember how we told you last night that we weren’t sure if the line that we put in yesterday was going to hold up?”

“Yeah,” I remember.

“Well, we weren’t sure then, but it definitely needs to be replaced. So we’ll get that line in and then you can come right back,” she states.

“I’m here, I’m standing right here outside the nursery, why can’t I come back? I want to be there to provide him comfort.” I’m grasping for a way to convince her.

“Well,” she concedes, “let me find out who’s going to do it and see what she says. Sometimes the nurses don’t like to have parents present during procedures.”

I ask who’s been assigned to Merritt, and learn it is Beth, known for getting lines in the first time. My heart settles slightly. I wait.

Her voice returns, “I talked to the nurse and she would rather not have you back here. I’m sorry.”

What the fuck. I knew I couldn't trust that woman.

I say it again, “Well, I want to be there.”

“I’m sorry,” she says, “can you come back in about a half hour? It will take less than 30 minutes.”

I know that I've reached the end of the line. My tone changes realizing that I don’t have say in what happens next. “Well, I’m staying right here at the nurses station.” My words are cold and hard, delivered through my teeth. “I’m waiting here.” I hope my physical presence will compel them to be efficient.

I give her my phone number and ask her to call me as soon as it’s over, then hand the phone back to the desk nurse who smiles meekly and says, “I’m sorry,” without consequence.

I want to kick the wall and fly into a rage, but I don’t. These people are the ones who give me access to my baby, I can only push back so much.

*

Although getting along was a necessary coping mechanism, I am remorseful for passively giving up Merritt’s right to have me with him. Part of the emotional challenge has been to reconcile these moments in our history, because it will always be what it was, even though I know so much more now.

When I first read Anonymous’s comment, I didn't recognize her words as judgement, unintentional or otherwise, but I see it now. To associate a mother’s dissatisfaction with any aspect of her mothering experience and reflect it directly onto her connection or satisfaction with the relationship that she’s building with her child is an unkindness to all involved. I have to believe that because we can’t know the nuance of emotion that other mothers feel in their own lives, more compassion and empathy is needed mother-to-mother. Are we not collectively our own worst critic? To feel judged causes unnecessary suffering too, as it tethers our ability as mothers to be present in our experience, and limits our capacity to accept our Truth and to bypass the shame, so that we can work through it to become the best versions of ourselves as mothers and women.

5 comments:

Anonymous' comment was extremely insensitive. A birth using an epidural is very, very different from a many-weeks premature baby that requires a NICU stay. I just had a friend deliver at 28-weeks on the dot and her baby has done fantastically from day one...but it still meant a multi-week NICU stay. And that is a very traumatic thing to not be in charge of your baby (and then therefore your life).

I think having to deal with a hospital in a multiple week capacity would be considered a trying time in one's life for anyone, regardless of it being birth related. Plus, it took you away from Roscoe & normal family life...

I could go on and on, but the point in that your opinion is very valid and rational and reasonable and I think it's great that you are letting yourself explore the messy feelings associated with a tough time in your life.

Oh it is so hard, your experience with Merritt has kept me strong through a pregnancy where I have been told due to medical complication they will be happy to deliver at 34 weeks by C-section if needs be to deal with my medical issues. I touch wood every day when I don't have problem and each passing week. I push myself to hope worse case scenario I make it to 37 weeks when they would first try induction before C-section. I NEED my baby to make it "full term" so I have the best chance of bonding with him in the most "natural" way. Thank you for your strength and willingness to share your experience so that I know that no matter what I can fight as hard as I need to have the best options for me and my child. On good days I imagine going past my due date and having to "wait" for him to decide when he is ready to come.

Your story makes my heart ache. I don't think I could have handled it all with as much outward patience grace as you did. You also handled the comment by anonymous very well. When I first read the comment, it made me bristle and I was so impressed by your response. Again, you handled that WAY better than I would have. I could be totally off, but it sounds like maybe anonymous is dealing with some deep seeded emotions revolving around her own children's birth and perhaps she can actually relate to your feelings, but would rather not face them head on?

You are handling this situation- both Merritt's birth and the insensitive comment- with such grace. My first son was in the NICU- for less than a week- but I tuly feel it affected our relationship. Like I said, he was my first, and I was the first one of all my friends to have a baby- I knew nothing. I let the doctors and nurses do everything and I did as I was told. I didn't think I had any other choice. I basically held him only to feed him. He's almost 4 now and has never been attached to me, ever. Then with my second, I had a great birth and got to be with my baby on my terms (when the nurses weren't bothering us- we got out of there as soon as those 24 hours were up.) It has been SUCH a different experience and I definitely grieve for the start my oldest and I had together. I wish I had the courage and knowledge you had with Merritt- good for you for standing up for what you believe as a mother and letting yourself sort through your feelings. Feelings are REAL no matter their source, and we can't change that or deny them.

Thank you for having the courage to share some of your story here. If I had been a first time mother I know that our experience would have looked very differently. It is very hard to carve out autonomy when we are in such vulnerable positions (as mothers with sick/fragile babies, as laboring women, etc.). I brought with me a lot of confidence and knowledge and STILL found it incredibly difficult. I see now that it had a lot to do with the particular hospital that we chose and (by default) the NICU. If we had been somewhere more progressive, they would have been encouraging best practices, not scoffing at them. As mothers we all do the very best that we can, and I hope that you have an outlet to continue to work through your experience--writing has been mine!